Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Unfortunately, there
are significant CRC screening disparities that result in higher rates of CRC-related morbidity and mortality for
minority and rural patient populations, particularly in the southern United States. The development of
interventions that capitalize on advances in communication, informatics, and computer science have great
promise for resolving theoretical and practical problems associated with CRC screening decision-making. The
purpose of this proposal is to test the efficacy of a patient-centered, tailored message intervention delivered via
virtual technology for increasing CRC screening within guidelines among racial/ethnic minority and rural
patients. We hypothesize that exposure to a minimally tailored CRC screening intervention delivered via VHT
will lead to improved cognitive processing of the intervention and increased adherence with initial and repeated
annual FIT screening completion as compared to a fully tailored, text-only intervention. This hypothesis will be
tested through two specific aims. In Specific Aim 1, we will conduct focus groups and think-aloud interviews
stratified by geography, gender, and racial/ethnic background to expand and pilot test an intervention that uses
a virtual human as a delivery mechanism for CRC screening information. In Specific Aim 2, patients (N =
3,000) will be recruited via primary care clinics and a secure, clinical data warehouse to complete a patient-
randomized test of the efficacy of the intervention for promoting initial and repeat FIT testing. Dependent
measures will be assessed via patient self-report and chart review. The proposed study will reduce health
disparities and associated morbidity and mortality due to CRC via increasing screening among racial/ethnic
minority and rural populations.
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